2021 Volume 17 Issue 1 Pages 50-53
A 67-year-old woman with stress urinary incontinence and third-stage rectocele underwent trans obturator tape surgery and perineoplasty. She complained of strong vulvar pain without incentives 21 days after surgery, and the pain continued thereafter. No resistance or tenderness was noted at the puncture site or along the tape route, and we did not observe an inflammatory reaction. We administered drug therapy as we believed that the pain was likely related to the mesh graft; however, treatment with nonsteroidal anti-inflammatory drugs, and pregabalin had no effect. Therefore, we decided to perform an operation to remove the mesh. Simultaneously, the patient started taking escitalopram oxalic acid, and her pain quickly disappeared. An existing guideline recommends the use of a serotonin noradrenaline reuptake inhibitor for chronic postsurgical pain, including pain after mesh graft surgery. In this case, a selective serotonin reuptake inhibitor was effective.
